With States About to Run Out of CHIP Money, Congress May Take Action

Arguments erupted on the House floor Thursday between Republican and Democratic leaders over the prospect of a vote this week on a GOP-only bill to renew funding for the Children's Health Insurance Program.

House Majority Leader Kevin McCarthy, R-Calif., announced the bill would be debated this week _ a plan opposed by Minority Whip Steny H. Hoyer, D-Md. Democrats have pushed to delay the House bill until an agreement is reached on a bipartisan solution to pay for it.

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"CHIP and community health centers, as the majority leader pointed out, have always been a bipartisan priority. Unfortunately, this bill did not come out of the committee as a bipartisan bill," Hoyer said. "Negotiations were not fruitful."

McCarthy shot back: "Let me set the record straight. Yes, it did come out of committee, and, yes, we did hold it up three times because your side of the aisle asked us to."

McCarthy said the reason the bill must be done this week is because Minnesota is about to run out of funds.

Federal funding for CHIP was exhausted Sept. 30, but nine states and territories including Minnesota received redistribution funds from the Centers for Medicare & Medicaid Services that are left over from previous fiscal year allotments.

McCarthy accused Democratic leaders of instructing their members on the Energy and Commerce Committee to oppose the ways that Republicans proposed to pay for the funding, but Hoyer denied that.

"As far as I know, the leadership didn't give any direction to the committee," Hoyer said. "The committee decided on its own that it that thought the cuts being put forward by the Republicans were very harmful to some very important programs and seniors."

The offsets in question in the CHIP bill include increasing premiums for Medicare beneficiaries who make over $500,000 a year and limiting Medicaid benefits for lottery winners. Another offset that Democrats want to revise would bill Medicaid after other insurance for recipients who use two types of coverage.

On the Senate side, Mark Warner and Tim Kaine, both Virginia Democrats, sent a letter on Thursday to Senate Majority Leader Mitch McConnell, R-Ky., requesting a vote on CHIP as soon as possible. The Senate Finance Committee approved a different bill earlier this month that does not specify how the funding would be offset.

Advocates' concerns Before the upcoming vote was announced, members of the nonpartisan Medicaid and CHIP Payment Access Commission gathered Thursday morning to discuss the status of CHIP legislation and what could be done to further progress on its passage.

"It's unfortunate from a beneficiary perspective and a public policy perspective that these people are held hostage to whether we have the right vehicle, what the legislative agenda is, what the offsets are," said Marsha Gold, a commissioner and consultant from the District of Columbia.

MACPAC data is often cited by other groups and even members of Congress as a guide for when states will exhaust all federal funds.

"Although there are funds available to spend in FY 2018, those funds will not be enough to cover state expenditures in fiscal 2018 if there are no new allotments made," said Joanne Jee, principal analyst for MACPAC. "And all states are expected to exhaust those funds at some point in fiscal 2018."

"CMS has been really working closely with states and been in frequent contact with them to determine the amounts of money they'll need and the timing for that as well," Jee told the commissioners.

The commission discussed different courses of action to stress the importance of renewing funding for CHIP as quickly as possible.

"I just wonder if we can provide some level of insight as we refresh the numbers to what the unwinding looks like and what the downstream variables are," said Christopher Gorton, a commissioner from Massachusetts. "Just because a state loses funding or runs out of funding on a certain day doesn't mean coverage ceases for every kid in CHIP that day."

"It's my view that we should update those numbers," said Penny Thompson, MACPAC's chair, pointing to the report MACPAC released earlier this year that pinpoints when the panel projects specific states will exhaust federal funds. Their latest projections are based on state data as of August. "We should prioritize getting a brief completed and make that information available to people at the earliest possible moment."

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